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Durotomy

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https://www.readbyqxmd.com/read/29223327/restoration-of-motor-function-after-operative-reconstruction-of-the-acutely-transected-spinal-cord-in-the-canine-model
#1
Zehan Liu, Shuai Ren, Kuang Fu, Qiong Wu, Jun Wu, Liting Hou, Hong Pan, Linlin Sun, Jian Zhang, Bingjian Wang, Qing Miao, Guiyin Sun, Vincenzo Bonicalzi, Sergio Canavero, Xiaoping Ren
BACKGROUND: Cephalosomatic anastomosis or what has been called a "head transplantation" requires full reconnection of the respective transected ends of the spinal cords. The GEMINI spinal cord fusion protocol has been developed for this reason. Here, we report the first randomized, controlled study of the GEMINI protocol in large animals. METHODS: We conducted a randomized, controlled study of a complete transection of the spinal cord at the level of T10 in dogs at Harbin Medical University, Harbin, China...
December 6, 2017: Surgery
https://www.readbyqxmd.com/read/29200173/medical-malpractice-claims-following-incidental-durotomy-due-to-spinal-surgery
#2
Wesley M Durand, Adam E M Eltorai, Govind Shantharam, J Mason DePasse, Eren O Kuris, Alicia E Hersey, Mark A Palumbo, Alan H Daniels
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Analyze medical malpractice verdicts and settlements associated with incidental durotomy. SUMMARY OF BACKGROUND DATA: Incidental durotomy is a common complication of spine surgery. While most intraoperative dural tears are repaired without sequelae, persistent CSF leak, infection, or neurological injury can yield adverse outcomes. The medicolegal implications of incidental durotomy are poorly understood...
December 4, 2017: Spine
https://www.readbyqxmd.com/read/29190646/risk-factors-for-incidental-durotomy-during-posterior-open-spine-surgery-for-degenerative-diseases-in-adults-a-multicenter-observational-study
#3
Hisatoshi Ishikura, Satoshi Ogihara, Hiroyuki Oka, Toru Maruyama, Hirohiko Inanami, Kota Miyoshi, Ko Matsudaira, Hirotaka Chikuda, Seiichi Azuma, Naohiro Kawamura, Kiyofumi Yamakawa, Nobuhiro Hara, Yasushi Oshima, Jiro Morii, Kazuo Saita, Sakae Tanaka, Takashi Yamazaki
Incidental durotomy (ID) is a common intraoperative complication of spine surgery. It can lead to persistent cerebrospinal fluid leakage, which may cause serious complications, including severe headache, pseudomeningocele formation, nerve root entrapment, and intracranial hemorrhage. As a result, it contributes to higher healthcare costs and poor patient outcomes. The purpose of this study was to clarify the independent risk factors that can cause ID during posterior open spine surgery for degenerative diseases in adults...
2017: PloS One
https://www.readbyqxmd.com/read/29186606/technique-of-minimally-invasive-cervical-foraminotomy
#4
Donald A Ross, Kelly J Bridges
BACKGROUND: Posterior cervical foraminotomy is a long utilized and commonly performed procedure, but has been supplanted in many cases by anterior procedures. With the advent of minimally invasive techniques, posterior foraminotomy may again deserve a prominent place in the treatment of cervical foraminal stenosis. OBJECTIVE: To report in detail a successfully utilized minimally invasive technique and the results in a large series of patients, by a single author...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29176490/incidental-durotomy-in-open-versus-tubular-revision-microdiscectomy-a-retrospective-controlled-study-on-incidence-management-and-outcome
#5
Evangelos Kogias, Jan-Helge Klingler, Pamela Franco Jimenez, Ioannis Vasilikos, Ronen Sircar, Christoph Scholz, Ulrich Hubbe
STUDY DESIGN: Retrospective case-control study. OBJECTIVE: To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. SUMMARY OF BACKGROUND DATA: Incidental durotomy occurs with a variable incidence of 3%-27% in spine surgery. The highest rate occurs in revision microdiscectomy. The intraoperative and postoperative management of dural tears varies in the literature and the definite impact on clinical outcome has to be clarified...
December 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29140956/comments-on-legal-implications-incidental-surgical-durotomy
#6
John P Kostuik
No abstract text is available yet for this article.
November 14, 2017: Spine
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#7
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29017307/incarceration-of-spinal-nerve-root-through-incidental-durotomy-as-a-cause-of-sciatica
#8
Young-Jin Kim
Incidental durotomies are a frequent complication during spinal surgery. Cerebrospinal fluid (CSF) leakage from a dural tear may be visually apparent intraoperatively, but occasionally, a tear may not be recognized during the procedure. We report our experience in 2 cases of postoperative incarceration of nerve root as a cause of sciatica, without CSF leakage intraoperatively. When durotomy attributable to surgical manipulation does occur, intraoperative identification is mandated. If a patient develops unexplainable postoperative pain and neurological deficits after lumbar discectomy, incarceration of nerve root should be considered in the differential diagnosis...
September 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28991059/analgesia-nociception-index-monitoring-during-supratentorial-craniotomy
#9
Lakshman K Kommula, Sonia Bansal, Ganne S Umamaheswara Rao
BACKGROUND: Objective monitoring of pain during and after surgery has been elusive. Recently, Analgesia Nociception Index (ANI) monitor based on the high frequency component of heart rate variability has been launched into clinical practice. We monitored analgesia during craniotomy using ANI monitor and compared it with cardiovascular parameters and response entropy (RE) of entropy monitor. MATERIALS AND METHODS: In 21 patients undergoing a craniotomy for a supratentorial lesion, we monitored ANI, heart rate (HR), mean arterial pressure (MAP), state entropy, and RE throughout the surgery...
October 5, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28922957/spinal-meninges-and-their-role-in-spinal-cord-injury-a-neuroanatomical-review
#10
Lukas Grassner, Andreas Grillhösl, Christoph J Griessenauer, Claudius Thomé, Volker Bühren, Martin Strowitzki, Peter A Winkler
Current recommendations support early surgical decompression and blood pressure augmentation after traumatic spinal cord injury (SCI). Elevated intraspinal pressure (ISP), however, has probably been underestimated in the pathophysiology of SCI. Recent studies provide some evidence that ISP measurements and durotomy may be beneficial for individuals suffering from SCI. Compression of the spinal cord against the meninges in SCI patients causes a "compartment-like" syndrome. In such cases, intentional durotomy with augmentative duroplasty to reduce ISP and improve spinal cord perfusion pressure (SCPP) may be indicated...
October 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28893299/risk-for-surgical-complications-after-previous-stereotactic-body-radiotherapy-of-the-spine
#11
Johannes Roesch, John B C Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha Jawad, Ronald Kersh, Daniel Letourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian Winey, Matthias Guckenberger
OBJECT: Stereotactic body radiotherapy (SBRT) for vertebral metastases has emerged as a promising technique, offering high rates of symptom relief and local control combined with low risk of toxicity. Nonetheless, local failure or vertebral instability may occur after spine SBRT, generating the need for subsequent surgery in the irradiated region. This study evaluated whether there is an increased incidence of surgical complications in patients previously treated with SBRT at the index level...
September 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#12
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28857968/risk-factors-and-management-of-incidental-durotomy-in-lumbar-interbody-fusion-surgery
#13
Frederik Enders, Amelie Ackemann, Simon Müller, Karl Kiening, Berk Orakcioglu
STUDY DESIGN: This is a retrospective study analysis. OBJECTIVE: In this retrospective study we evaluated risk factors for incidental durotomy and its impact on the postoperative course. SUMMARY OF BACKGROUND DATA: Lumbar interbody fusion (LIF) is increasingly applied for the treatment of degenerative instability. A known complication is incidental durotomy. MATERIALS AND METHODS: A cohort of 541 patients who underwent primary LIF surgery between 2005 and 2015 was analyzed...
August 28, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28765795/inpatient-versus-outpatient-anterior-cervical-discectomy-and-fusion-a-perioperative-complication-analysis-of-259-414-patients-from-the-healthcare-cost-and-utilization-project-databases
#14
Shearwood McClelland Iii, Peter G Passias, Thomas J Errico, R Shay Bess, Themistocles S Protopsaltis
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is one of the most common operations utilized to address pathology of the cervical spine. Few reports have attempted to compare complications associated with inpatient versus outpatient ACDF. METHODS: The Nationwide Inpatient Sample (NIS) from 2001-2012 and the State Ambulatory Services Database (SASD) for New Jersey (NJ) from 2003-2012 were used for analysis. Patients receiving ACDF (defined as anterior cervical fusion (ICD-0 code=81...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28736354/novel-technique-of-percutaneous-fat-graft-for-repair-of-persistent-large-pseudomeningocele
#15
Gabrielle Santangelo, Tyler Schmidt, Mithra Gonzalez, Per-Lennart Westesson, Howard Silberstein
BACKGROUND: Pseudomeningocele is an uncommon but problematic complication in lumbar spine surgery. Initial conservative measures frequently are successful, but persistence requires additional management. The current surgical approach can involve a range of techniques, including blood patches, hydrogel/fibrin sealants, drains, open surgical repair of the dura, or a combination of the all techniques if symptoms persist. This report demonstrates a novel technique for repair via a percutaneous approach to deliver an autologous fat graft into the pseudomeningocele...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735765/incidental-durotomy-during-total-en-bloc-spondylectomy
#16
Noriaki Yokogawa, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Hiroyuki Tsuchiya
BACKGROUND CONTEXT: The incidence of incidental durotomy (ID) during total en bloc spondylectomy (TES) tends to be higher than that during other spinal surgeries because of the peculiarities of TES, including its highly invasive nature, epidural tumor extension, and use in patients who often have complicated medical backgrounds. However, there have been no detailed reports on ID associated with TES. PURPOSE: The study aimed to investigate ID during TES in detail...
July 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#17
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28720995/tuberculosis-the-great-masquerader-presenting-as-a-dumb-bell-shaped-intradural-extramedullary-tumor-in-a-20-year-old-female
#18
Mukunth Rajgopalan, Amit Srivastava, Ish K Dhammi, Anil K Jain
Tuberculosis has been known as the great masquerader for its varied presentations. We present an extraordinary case of a 20-year-old female who presented with paraparesis of two months. MRI showed an intradural, extramedullary dumb-bell-shaped, spinal cord tumor. With a provisional clinicoradiological diagnosis of benign nerve sheath tumor (schwannoma/neurofibroma), laminectomy was done. But after durotomy, frank pus was drained from the site of lesion and the laboratory investigations of the tissue and pus obtained proved it to be tubercular...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28688062/giant-thoracic-discs-treatment-outcome-and-follow-up-of-33-patients-in-a-single-centre
#19
Saurabh Kapoor, Meriem Amarouche, Farah Al-Obeidi, Jean Marie U-King-Im, Nick Thomas, David Bell
PURPOSE: To help guide treatment strategies and create insight into functional outcomes in patients with Giant herniated thoracic discs (GHTD), which are defined as occupying more than 40% of spinal canal. METHODS: Authors did a retrospective analysis of prospective cohort of 33 cases of GHTD, using clinical letters, notes, and telephonic questionnaires to determine their pre and postoperative functional status, surgical details, and complication rates. 16 males and 17 females operated between 2006 and 2014 were included in the study...
July 7, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28660101/large-compressive-pseudomeningocele-causing-early-major-neurologic-deficit-after-spinal-surgery
#20
Brandon L Raudenbush, Andrew Molinari, Robert W Molinari
STUDY DESIGN: Retrospective review. OBJECTIVES: Large compressive pseudomeningocele causing a major neurologic deficit is a very rare complication that is not well described in the existing literature. METHODS: Institutional review board consent was obtained to study 2552 consecutive extradural spinal surgical cases performed by a single senior spinal surgeon during a 10-year period. The surgeon's database for the decade was retrospectively reviewed and 3 cases involving postoperative major neurologic deficits caused by large compressive pseudomeningocele were identified...
May 2017: Global Spine Journal
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